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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wvvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />l6111-1o/h wl� R/" �-Vacll &1,6 <br />PROJECT ADDRESS <br />l�as l/�ctt� y luc�c ��'l5 A9�a90���/�� <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City Stale/Zip Phone <br />otc) KPIP <br />Electrical Contractor Mail Address City State/Zip Phone <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: 1cle� <br />NOTE: WIRING IN NON -DWELLINGS IS RFQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and <br />rorrect. All provisions of laws and ordinances governing this type or work will be completed <br />whether specified herein or not. The granLng or a permd does not presume to givz authonfy fo <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application Is made nd I comply with the State Contractors Law 18,27 RCW and <br />296.200 WAC. <br />r C'(o S /uL <br />Sta alure ale <br />